Thursday, July 9, 2009

Allow Me To Explain... Healthcare Reform in the US is Doomed

I had some people comment on my last rant about health care for all in this country. What most people DO NOT understand is that the current policy proposal is much like the system that Massachusetts has been running for years. And, contrary to the opinions from those who feel like giving free medicine to all, it is not working. And it is harming the welfare of doctors, specifically those in specialty fields. And it is creating worse health care.

Read this and then I'll happily debate with you over the current proposal. I'm all for healthcare reform. I really am. But I'm not for agreeing with, "oh yea, let's cover everyone with some extra taxes and cost cutting measures". Why don't we actually solve the problems that exist rather than throw an expensive band aid at it?.

From the ACC:

July 8, 2009

If you don't read another edition of this publication, read this one. Then read it again and get ready to join the ACC's fight for the viability of your practice! CMS late last week proposed mind-boggling cuts to cardiology that could be 30 percent or higher beginning in 2010. Taken together with the payment cuts cardiology already has experienced, this wrongheaded proposal represents a real threat to your practice and to the patients you serve.

Let's break down the horrible numbers. The proposed rule slashes Medicare payments by more than 11 percent for the average cardiology practice as a result of a badly managed practice expense survey. Out of thousands of cardiology practices solicited this survey is based on input from approximately 50. Somehow this small sample size showed that CV practices have experienced a 30 percent reduction in practice costs.

Does that match up to the numbers in your practice? Of course not. This survey has no credibility and CMS chose to disregard the standards it previously put in place to ensure the quality of practice expense data. We believe this is a significant departure from previous policy and may be a violation of the law. It is ironic that the agency that purports to support an evidence-based approach to medicine is making major decisions based on shoddy and incomplete data.

It gets worse! As if the 11 percent were not bad enough, most of the core cardiology services face cuts ranging from 20 to 40 percent. Add in the regularly scheduled SGR cuts of more than 20 percent and practices could see possible payment cuts ranging from 25 to almost 50 percent.

This is not what we meant by putting quality first. The timing couldn't be worse. Just as we're moving forward with real proposals for health care reform that would improve quality, reduce waste, slow spending and improve the viability of CV practices, along comes this CMS hatchet job. Arbitrary price controls do not equal reform and will only lead to greater disparities in health care.

That's the bad news. The good news is that this proposal is subject to revision. Your ACC is fighting this change at all levels through CMS, Congress and the Administration. ACC President Fred Bove, and your elected officers and Washington-based staff are all over this crisis on your behalf.

Working closely with our partner cardiovascular societies we are developing a detailed response to CMS and working the halls of Congress to bring political pressure to bear on the agency. We are reaching out beyond cardiology to engage other specialties like oncology that also face daunting cuts that will inevitably impact patient diagnosis and treatment. On the regulatory side, ACC staff is working closely with the Advocacy Steering Committee and the CV RUC to prepare a substantive analysis and response to this proposed rule. We anticipated this action from CMS and have identified technical expert consultants who can assist us with our analysis and help propose alternatives.

We have been rocked by this proposal and now it's time to roll! Here are four key ways you can get involved:

* The ACC has launched a grassroots campaign to get Congress involved. Go to and send a letter to your members of Congress explaining in detail how 20 to 40 percent cuts will impact your ability to practice medicine.
* Take part in a video campaign that can be shared with members of Congress, regulatory officials and the public. Upload a 30-40 second video about the impacts of large-scale cuts on your ability to provide patients with the right care at the right time. Email Molly Nichelson at to have it posted for you on ACC Advocacy's YouTube" site. Don't own a video camera? Submit your story via the ACC's online forum, "The Lewin Report."
* Take part in the ACC's "Cut the Cuts Roadshow" and volunteer to give your own or facilitate an ACC-taped presentation on the implications of the cuts on cardiology to your hospital or practice group. Email for more information
* Get involved with your local Chapter's efforts: this could include volunteering your practice to host a "Cardiologist for a Day" event, writing op-eds and more. Go to for contact information or email

Saturday, July 4, 2009

Free Magazine Subscriptions - Forbes and BusinessWeek


Two of my favorite magazines. Well worth it. Free. If anyone reads magazines anymore. Actually, I like magazines because they're very portable and easy to read. Especially in the bathroom. Newspapers are too inconvenient. Thus the demise of newspapers.

Anyway, here are the links. They're free. No credit cards. Just answer a few questions and give 'em your address. I usually fill out a fake name. And use my spam email address so as not to be bombarded by spam. I recommend you do the same. You don't have a spam email address you say? Well time to create one. By the way, Forbes is an awesome magazine for those who haven't spent much time reading it.

Business Week (here)

Forbes (here)

Wednesday, July 1, 2009

Obama is Making Me a Republican! Americans Need To Take Responsibility!

I voted for him. Much to the dismay of my family. Not because they are war mongering Republicans, but because they are fiscally conservative and scared to death of a Democrat's "big government".

I shunned them. Praising Obama. Loving the thought of having a leader the world respected. Hopeful that we wouldn't be mired in war for the rest of my life. Scorning Bush at every chance and how he single-handedly ended the supremacy of the greatest nation the world had ever seen.

The first six months of Obama's presidency, I was elated. He was taking a different tone and stance on everything. I admired him and loved the direction America was going. Then slowly, cracks appeared in his armor. At once, a person I had thought was a moderate Democrat has become the most left winged socialist I could have imagined. I really hope this is just a figment of my imagination. And that I'm jumping the gun. But he's coming dreadfully close to mirroring some Chavezian policies.

I was raised in a family that rewarded hard work and dedication to school and life. It's part of what drove me to get my MBA and continue to push myself to achieve, even when others viewed my situation as ideal. I've learned not to take things for granted: life, friends, family, finances, and happiness.

I've watched as my parents worked tirelessly to provide for my brother and me. To give us things they never had so that we could live a life they had only dreamed of. And they succeeded.

But change is upon us if Obama has his way. See, we're not being rewarded for hard work and dedication anymore. And we're not at fault for mistakes we make. It's called responsibility. And there doesn't seem to be any culpability anymore. It's disgusting me! My dad is making less money than ever, as a physician. 30 some years of service. And he earns less than he ever did. What other field pays you less the longer you work? Name one. Sure, some of you will scoff... "he's a doctor, he earns plenty". Yea, he spent 10+ years after college in training (that's ten less earning years). He saves people's lives. He's on call. He spends the worst 30 seconds of people's lives with them - having to tell people they are dying. Or telling family members their loved ones have died. If you're complaining about prices. Take it up with your insurance provider. They're making plenty. But enough about that.

America used to be the Land of Opportunity - where your dreams came true if you worked hard. People aren't working hard anymore. They're sitting around and waiting for handouts. This sounds sustainable. Maybe a little adversity would actually make us stronger.

Just my 2 cents.